Neuromuscular ultrasound for taxane peripheral neuropathy in breast cancer

Muscle Nerve. 2020 May;61(5):587-594. doi: 10.1002/mus.26833. Epub 2020 Feb 24.

Abstract

Background: Our study aim was to evaluate neuromuscular ultrasound (NMUS) for the assessment of taxane chemotherapy-induced peripheral neuropathy (CIPN), the dose-limiting toxicity of this agent.

Methods: This cross-sectional study of breast cancer patients with taxane CIPN measured nerve cross-sectional area (CSA) by NMUS and compared with healthy historical controls. Correlations were determined between CSA and symptom scale, nerve conduction studies, and intraepidermal nerve fiber density (IENFD).

Results: A total of 20 participants reported moderate CIPN symptoms at a median of 3.8 months following the last taxane dose. Sural nerve CSA was 1.2 mm2 smaller than healthy controls (P ≤ .01). Older age and time since taxane were associated with smaller sural nerve CSA. For each 1 mm2 decrease in sural nerve CSA, distal IENFD decreased by 2.1 nerve/mm (R2 0.30; P = .04).

Conclusions: These data support a sensory predominant taxane neuropathy or neuronopathy and warrant future research on longitudinal NMUS assessment of CIPN.

Keywords: breast cancer; chemotherapy; neuropathy; taxane; ultrasound.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Albumins / adverse effects
  • Ankle
  • Antineoplastic Agents / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Cross-Sectional Studies
  • Docetaxel / adverse effects
  • Electrodiagnosis
  • Epidermis / pathology
  • Female
  • Forearm
  • Humans
  • Leg
  • Median Nerve / diagnostic imaging*
  • Median Nerve / physiopathology
  • Middle Aged
  • Nerve Fibers / pathology
  • Neural Conduction
  • Paclitaxel / adverse effects
  • Peripheral Nervous System Diseases / chemically induced
  • Peripheral Nervous System Diseases / diagnostic imaging*
  • Peripheral Nervous System Diseases / pathology
  • Peripheral Nervous System Diseases / physiopathology
  • Pilot Projects
  • Prospective Studies
  • Sural Nerve / diagnostic imaging*
  • Sural Nerve / physiopathology
  • Taxoids / adverse effects*
  • Tibial Nerve / diagnostic imaging*
  • Tibial Nerve / physiopathology
  • Ultrasonography / methods*
  • Wrist

Substances

  • 130-nm albumin-bound paclitaxel
  • Albumins
  • Antineoplastic Agents
  • Taxoids
  • Docetaxel
  • Paclitaxel